June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Validation of embossing technique for subretinal drusenoid deposits on color fundus photos
Author Affiliations & Notes
  • Yang Fei
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Shin Kadomoto
    Doheny Eye Institute, Los Angeles, California, United States
    University of California Los Angeles, Los Angeles, California, United States
  • Emanuel Mordechaev
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Brandon Le
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Katy Tai
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Alauddin Bhuiyan
    iHealthScreen Inc, New York, New York, United States
  • SriniVas R Sadda
    Doheny Eye Institute, Los Angeles, California, United States
    University of California Los Angeles, Los Angeles, California, United States
  • Roland Theodore Smith
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Footnotes
    Commercial Relationships   Yang Fei None; Shin Kadomoto None; Emanuel Mordechaev None; Brandon Le None; Katy Tai None; Alauddin Bhuiyan None; SriniVas Sadda Centervue, Heidelberg, Code C (Consultant/Contractor); Roland Theodore Smith None
  • Footnotes
    Support  Regeneron Pharmaceuticals Investigator-Initiated Study, Research to Prevent Blindness Challenge Grant (RTS and RBR)
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2139. doi:
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      Yang Fei, Shin Kadomoto, Emanuel Mordechaev, Brandon Le, Katy Tai, Alauddin Bhuiyan, SriniVas R Sadda, Roland Theodore Smith; Validation of embossing technique for subretinal drusenoid deposits on color fundus photos. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2139.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Drusen are easily detected on color fundus photographs (CFPs), but subretinal drusenoid deposits (SDDs), the other common lesions of age-related macular degeneration (AMD), are not. Thus, a technique to increase the sensitivity for detecting SDDs in existing CFPs could facilitate re-calibration of conclusions of important AMD studies based on CFPs alone. Going forward, screening for SDDs with CFPs would be enabled in primary care settings. In this cross-sectional study, we expand previous work with a novel image embossing technique to improve SDD detection in CFPs.

Methods : In this study, we assessed 1115 eyes of 655 subjects (mean age 63.3±14.8 years) with high quality CFP and spectral-domain optical coherence tomography (SD-OCT), recruited from a medical retinal clinic. Eyes were classified into three categories by retinal specialist: any-stage AMD without other retinal pathology (dxAMD), no significant retinal pathology (Healthy; e.g. routine negative check-up), and retinal pathology with or without AMD (dxRET). Ground truth identification and staging by eye for the presence of SDDs was established on SD-OCT by masked reviewers. Same-visit CFPs were embossed using previously-described custom software to automatically detect and enhance all light/dark boundaries of the original image (Figure 1). CFPs and embossed CFPs (EPs) were graded separately twice for presence of SDDs by masked graders. Uncertain determinations in any assessment were adjudicated by a retinal specialist. Performance by EPs in detection of SDDs Grade 2 or higher was compared to the SD-OCT ground truth.

Results : The prevalence of SDDs of Stage 2 or higher was 28.70% of all eyes (Table 1). When compared to ground truth SD-OCT, EP had an accuracy of 90.11% across all eyes, compared to 70.7% for CFPs. The sensitivity and specificity of EPs were 83.44% and 93.08%, with positive and negative predictive values of 82.92% and 93.32%, respectively. Diagnostic values remained high after categorization into pre-specified subgroups as dxAMD (17.0%), Healthy (35.2%), and dxRET (47.8%).

Conclusions : By detecting SDDs in embossed CFPs, vision science researchers may more accurately and completely assess the SDD phenotype of AMD from large historic studies with CFPs that had only been assessed for drusen. The sensitivity of EPs for SDDs could augment detection of AMD by artificial intelligence now proposed for screening in primary care clinics.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

 

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